Colorectal cancer at Tribhuvan University Teaching Hospital- a retrospective study 2064-2067

Abstract

Master Theses Project, Programme in Medicine Colorectal cancer at TUTH – a retrospective study 2064-2067 Lotten Lord, 2013 Department of Surgery, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden Background Colorectal cancer (CRC) is one of the most common types of cancer worldwide. In Asia the incidence of CRC is increasing and is now the third most common malignant disease. There is limited research on CRC in Nepal. It is of great importance to investigate this issue further. Aim The aims were to describe demographic data regarding patients treated for CRC at Tribhuvan University Teaching Hospital (TUTH) in Kathmandu, Nepal, during a three year period (2007-2010), symptoms and signs during first consultation, localisation and staging, and type of surgical procedure. Furthermore to investigate differences between age, sex, ethnicity with regard to incidence of malignant tumors, and its staging. Methods Medical records of patients (n = 83) with primary CRC at TUTH were reviewed during a three years period. Results Colon was most frequent site (58 %) of malignant tumor, colon to rectal ratio being 1.4:1. Mean age in the total group was 53.6 ± 15.6 years. Number of patients under 40 years of age 4 was 13 (16.0 %). There were 53 men and 30 women, the ratio being 1.8: 1. About 50 % of the patients had Stage III-IV. No significant differences between age, sex, ethnicity with regard to occurrence of CRC, and staging of tumor were found. Conclusions This study confirms an increasing number of CRC at TUTH compared to a study made in 2002. Though in contrast to other studies a lower occurrence of CRC among patients under 40 years of age (16 %) was found. Although earlier assumed genetic heritage in the two bordering countries, China having an incidence rate 3.8 times higher than India, this difference was absent at TUTH, indicating environmental factors to contribute more than genetics. A remarkable high proportion of advanced stage of presentation account for poor prognosis. The number of patients is limited and therefor further studies with larger materials are required. Key words: Colorectal cancer, Ethnicity, Localization, Nepal, Staging, Symptom and Sign